Training and fairer payments would increase caries prevention in practice

PubMed, Embase, PsycoInfo, Scielo, Scopus, Web of Science, BBO, Lilacs and York databases supplemented by Google scholar. Qualitative studies with findings derived from individual or group interviews and structured questionnaires reporting factors that drove dentists towards or away from incorporating caries preventive measures were considered. Two reviewers conducted selection independently. Data were abstracted independently by two reviewers and a qualitative metasummary carried out. This involves the extraction, grouping and formatting of findings and the calculation of frequency and intensity effect sizes in order to provide mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings. Seven qualitative studies and 41 surveys (36,501 participants) were included. The reports were grouped together into six categories that were judged to be topically similar; education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. Biologicism (27%), low remuneration (25%), length of time since graduation (22%) and male dentists (19%) were found to be the highest frequency effect size driving dentists away from using preventive approaches, and team work (21%), post-graduation (12%) and professional understanding of the benefits (12%) were identified as the main reasons for dentists' adherence to preventive measures. Despite the questionable quality of the included reports the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favour of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision-making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.